A school nurse is conducting hearing screening procedures in an elementary school. Which of the following instructions should the nurse provide when performing the Rinne test?

A) After I place the tuning fork on your scalp, tell me if you hear the sound better in one ear or the same in both ears.
B) Use your finger to close one ear while I whisper some numbers into your other ear.
C) After I place this tuning fork behind your ear, tell me when you no longer hear the sound.
D) You’ll wear headphones and press the button when you hear a sound.

C

This test is a hearing evaluation that compares air conduction and bone conduction of sound.

A palliative care nurse is teaching a client who has cancer about the services that are available for the client. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

A) If I begin palliative care, I will have to stop my chemotherapy.
B) I can begin palliative care when I have less than 6 months to live.
C) This type of care can help me with pain control.
D) My family will not be involved with this type of care program.

C

A nurse is assessing a new client. Which of the following information should the nurse include in the cultural portion of the assessment?

A nurse is collecting demographic data as a part of a community assessment. Which of the following information should the nurse include?

A) Racial distribution
B) Family genograms
C) Number of open water sources
D) Presence of condemned buildings

A

A nurse is caring for a client who has AIDS and is experiencing rapid weight loss. Which of the following actions should the nurse take first?

A) Examine the client’s oral mucous membranes.
B) Encourage the client to consume 1.2 to 2.0 g/kg of protein daily.
C) Recommend the client increase her daily calorie intake by 25%.
D) Teach the client about findings that should be reported to the provider.

A

A home health nurse is caring for a client who has breast cancer. Which of the following assessment findings should the nurse identify as an indication that the client is coping effectively?

A home health nurse is scheduling client visits for the day. Which of the following clients should the nurse plan to visit first?

A) A client who is 10 days postoperative following a mastectomy and needs to have surgical staples removed.
B) A client who has diabetes mellitus and reports new erythema to the left foot.
C) A client who has COPD and needs a follow-up visit related to home oxygen therapy.
D) A client in a hip spica cast who reports pruritus under the cast.

B

A CHN is assessing a group of clients for risk factors of abusive behaviors. Which of the following findings should the nurse identify as a risk factor for developing violent behavior?

A) A client states he witnessed his mother physically mistreat his father.
B) A client states that her mother-in-law provides childcare while she is working.
C) A client participates in volunteer activities in the community.
D) A client lives in the same neighborhood where he spent his childhood years.

A

A school nurse is teaching health promotion to a group of staff members who sit at a desk and use a computer for eight hours at a time. Which of the following information is the priority for the nurse to include?

A) Take a walk after work.
B) Point and flex your toes periodically.
C) Have your visual acuity assessed regularly.
D) Adjust your chair so that your elbows are at desk height.

B

A case manager is planning an educational program for a client who has diabetes mellitus. Which of the following activities should the nurse include when using the psychomotor domain of learning?

A) Review a color diagram of the food pyramid with the client.
B) Show the client a video about how to monitor blood glucose levels.
C) Observe the client’s technique for drawing up insulin.
D) Give the client a pamphlet about foot care.

C

A nurse manager at a community health clinic is presenting an in-service for nurses about assessing clients for abuse. Which of the following statements by a nurse indicates an understanding of the teaching?

A) Once I determine that a client is not at risk for abuse, I do not need to ask about it at future visits.
B) I should not document the name of the person the client accuses of the abuse in the client’s medical record.
C) I should wait until I see signs of physical abuse before I help the client develop a safety plan.
D) I should refer a client for a rape kit examination if she reports sexual assault within the previous 24 hours.

D

A nurse is teaching a client who has a new diagnosis of hepatitis A how to prevent the spread of the virus. Which of the following instructions should the nurse include?

A CHN is developing a plan of care for a client who is hispanic. Which of the following actions should the nurse include in the plan?

A) Avoid using hand gestures when working with the client.
B) Use therapeutic touch during conversation.
C) Discourage the client from using a faith healer.
D) Maintain direct eye contact when speaking with the client.

B

They might use face, hand, and body gestures to express themselves and consider touch a gesture of caring and compassion.
They might seek care from a faith healer, a Santero priest, or a yerbero.

Direct eye contact is disrespectful.

A nurse is conducting an educational session at an assisted living facility for a group of clients who have osteoporosis. Which of the following statements should the nurse include in the teaching?

A) It is important to avoid weight-bearing exercises.
B) Decrease your dietary intake of folate.
C) Increase your daily intake of leafy green vegetables.
D) It is important to spend 30 minutes each day exposed to sunlight.

C

A hospice nurse is teaching about expected grief reactions with the family of a client who has end-stage pancreatic cancer. Which of the following information should the nurse include?

A) It is common to experience a persistent state of sadness while grieving.
B) Disturbances in your self-esteem is an expected grief reaction.
C) You will feel a sense of hopelessness throughout the grieving process.
D) A component of healthy grieving is the ability to openly express your anger.

D

Emotions will fluctuate frequently.
A persistent state of sadness is a sign of clinical depression.
Disturbances of self-esteem is a sign of clinical depression.

A nurse is preparing an educational program about influenza for a group of CHNs. Which of the following activities should the nurse include as an example of tertiary prevention?

A) Offer classes to elementary school teachers about handwashing.
B) Provide information to occupational nurses about reasons for employees to not come to work.
C) Administer antiviral medications within 48 hours to clients who have manifestations of influenza.
D) Provide immunizations at long-term care facilities.

C

An occupational health nurse is planning to use an interpreter during an educational session with a group of migrant workers who do not speak the same language as the nurse. Which of the following actions should the nurse take? (SATA)

A) Instruct the interpreter to guide the nurse in providing information in a culturally-sensitive manner.
B) Ask the interpreter to add information she feels may be necessary.
C) Choose an interpreter who speaks the worker’s languages and dialect.
D) Evaluate the interpreter’s approach to clients prior to the educational session.
E) Encourage the interpreter to paraphrase the worker’s questions and responses.

A, C, D

A nurse in a rural health clinic is caring for a client who has heart failure. The client states, “I’m not going to take any more medicine.” Which of the following responses should the nurse make?

A) Why did you decide to stop your heart medicine?
B) Can you tell me more about your decision to stop your medicine?
C) Don’t you know what stopping your medication will do to your heart?
D) Don’t you think your doctor knows what’s best for your heart?

B

A CHN is planning an educational program for farmers about occupational health risks. Which of the following risks should the nurse include?

A CHN is working to meet the health care needs of residents in a rural community. Which of the following characteristics should the nurse identify as a barrier to health care resources for this population?

A) Less autonomy in providing client care.
B) Disinterest by members of the population in providing input for community health programs.
C) Lack of cohesiveness among community members.
D) Unavailability of outreach services.

D

A CHN is teaching a client who is overweight about steps to take to begin an exercise program. The nurse should identify that which of the following statements is an indication that the client understands the teaching?

A) I will need to purchase exercise equipment before I can start.
B) I should try to perform aerobic exercise for an hour a day, 5 days a week.
C) I will see my doctor before beginning an exercise program.
D) I should avoid participating in weight-lifting exercises.

C

A PHN is participating in a community planning committee for disaster preparedness for a local community that is at risk for hurricanes. Which of the following information should the nurse contribute to the plan?

A) A list of residents who have experienced a hurricane in the past and will not need evacuation.
B) A list of areas within the community where residents speak English as a second language.
C) How to activate the local medical facility’s emergency-management plan.
D) The name of the individual who is necessary to implement the plan.

B

A nurse is providing blood pressure screenings for older adults as a local community center. Which of the following should the nurse identify as increasing a client’s risk for developing HTN?

A) BMI < 30
B) Daily walking routine
C) African American
D) HDL > 70

C

A home health nurse is planning care for the day. Which of the following clients should the nurse visit first?

A) An older adult client who was treated in the ED last night for a stage III pressure ulcer.
B) A school age child who was treated in the ED last night with status asthmaticus
C) An older adult who has a newly prescribed antihypertensive medication and needs a BP check
D) A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing.

B

A CHN is working in a mobile health care clinic. Which of the following clients should the nurse assess first?

A) Requires removal of sutures from a laceration.
B) Temperature of 100.1
C) Has COPD and O2 Sat of 90%
D) New onset of confusion and slurred speech

D

A nurse in a community center is preparing to administer a tuberculin skin test to multiple clients to screen for TB. Which of the following actions should the nurse take?

A) Prepare the outer aspect of the upper arm for the injection.
B) Insert the needle at a 45 degree angle.
C) Inject 0.1 mL of purified protein derivative.
D) Create a wheal that measures about 15 mm in diameter.

C

A PHN is monitoring medication compliance for a group of migrant workers who are being treated for TB. The nurse should use information from which of the following resources to assist with this process?

A school nurse is conducting visual acuity testing for a school-age child. Which of the following actions should the nurse take?

A) Allow the child to keep her glasses on during the testing.
B) Have the child stand 5 feet away from the Snellen letter chart.
C) Progress to the next line once the child reads two symbols correctly.
D) Begin the test by instructing the child to use both eyes to read the chart.

A

A PHN is developing a visual health program by using a community-oriented approach. Which of the following interventions should the nurse include?

A) Teach a client who has a vision loss about safety in the home environment.
B) Provide genetic counseling to the family of a newborn who has congenital cataracts.
C) Consult with the local school nurse to schedule yearly vision screenings for students.
D) Develop a plan of care for a client who has newly diagnosed with glaucoma.

C

A PHN is planning care for four clients. Which of the following interventions should the nurse recognize as tertiary prevention?

A) Providing chemoprophylaxis for malaria to a client who is traveling to mosquito-infested countries.
B) Performing a serological screening for HIV for a client who is pregnant.
C) Participating in partner notification for a client who has an STI
D) Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jiroveci

D

Because it is is tertiary prevention.

A nurse in a county heath department is caring for a client who states, “I’ve been drinking too much in the evenings since my mom died last year. Which of the following responses should the nurse make?

A) It sounds like you are probably an alcoholic.
B) Don’t you think your family is being affected by your drinking?
C) Can I give you some information about Alcoholics Anonymous?
D) I don’t think your mom would have approved of your drinking.

C

A PHN is developing a presentation for local daycare providers about infectious childhood diseases. Which of the following statements should the nurse include?

A) Respiratory syncytial virus is spread through contact with respiratory secretions from an infected person.
B) Rotavirus infections in children peak during the summer months.
C) Children who have fifth disease will exhibit bloody diarrhea.
D) Antiviral medications shorten the duration of a shigella infection.

A

A CHN suspects an outbreak of scabies in the local area. Which of the following actions should the nurse take first?

A CHN is discussing the concept of epidemiology with a coworker. Which of the following interventions should the nurse provide as an example of the use of the principles of epidemiology?

A) Conducting screenings for dental caries in the local school system.
B) Reviewing county health records for data on cases of chickenpox.
C) Providing a client with information about preventing STIs.
D) Documenting medication compliance for clients who have tuberculosis.

B

A CHN is assigned to lead a county-level environmental task force. Which of the following activities should the nurse direct the task force to complete first?

A CHN is teaching a client who was newly diagnosed with active pulmonary tuberculosis about disease transmission. Which of the following information should the nurse include?

A) Household members should be placed in respiratory isolation.
B) The client should use disposable utensils during meals.
C) Household members should take isoniazid for 6-12 months.
D) The client should have a repeat purified protein derivative test in 3 months.

C

The daughter of a client who is terminally ill and at the end of life approaches a hospice nurse and asks what she can do to help relieve her father’s pain. Which of the following interventions should the nurse suggest?

A) Give the client brief hand massages.
B) Increase the illumination in the room.
C) Place a warm cloth on the client’s forehead.
D) Administer citalopram when the client is agitated.

A

A CHN has been contacted regarding a client diagnosis of influenza type A in an adult day care. Which of the following actions should the nurse take to assist in the prevention of an outbreak?

A) Administer antiviral medication to clients at the facility.
B) Schedule immunizations for clients at the facility.
C) Recommend that the day care center close for 2 weeks.
D) Give immune globulin to clients at the facility who have early manifestations of influenza.

A

Antivirals will provide immediate protection.

Immunizations would only help if they haven’t already been exposed.

A nurse in a rural community is planning education for a young adult client who is a migrant farm worker. Which of the following actions should the nurse include? (SATA)

A PHN is working in a community that has a population of 24,096. There are 2,096 existing cases of heart disease within the population. The nurse can determine which of the following from this information?

A home health nurse is assessing an older adult client who is taking captopril to treat heart failure. Which of the following findings should the nurse identify as an adverse effect of this medication?

A) Weight gain
B) Ataxia
C) Photophobia
D) Dry cough

D

A nurse is developing an educational program about bioterrorism and smallpox. The nurse should include in the teaching that the smallpox rash is expected to first appear in which of the following locations?

A) Face
B) Posterior shoulders
C) Abdomen
D) Lower extremities

A

A nurse is assessing the risks and benefits of meal delivery services for an older adult client who lives alone and has no transportation. Which of the following ethical principles is the nurse demonstrating?

A nurse is conducting a home visit with a female client who reports a history of intimate partner abuse. The nurse should identify that which of the following findings places the client at greatest risk for domestic violence?

A) The client is at 13 weeks of gestation.
B) The client states she is leaving her partner.
C) The client recently started a new job.
D) The client visits friends without her partner’s knowledge.

b

A case manager is developing a discharge plan for a client who has a spinal cord injury and is in a rehabilitation facility. Which of the following actions should the nurse take first?

A) Hold a care conference with the client and his family to discuss treatment options.
B) Contact service providers to determine the availability of services offered.
C) Determine the client’s ability to perform self-care.
D) Evaluate the client’s satisfaction with the case manager’s services.

C

A nurse at a county health clinic is caring for a client who has recently assumed the role of primary caregiver for her mother. Which of the following statements by the client indicates that she is experiencing role conflict?

A) I feel overwhelmed with not having enough time for my mom as well as my children.
B) I hope my siblings will be able to visit and help care for mom for a few days.
C) I am glad that my job is flexible, so I can accommodate my mom’s needs.
D) I don’t think my partner likes having to help more with the household chores.

A

A nurse is planning to teach a community group about the meningococcal vaccine. The nurse should identify that which of the following clients should receive the vaccine?

A) A client who is traveling to northern Europe.
B) An infant who has bronchiolitis.
C) An infant who is 4 weeks old.
D) A client who is moving into a college dormitory.

D

A PHN is providing information to a client who has alcohol use disorder and is asking about treatment. Which of the following statements should the nurse identify as an indication that the client understands the information?

A) I will not have to completely stop drinking alcohol if I go into an inpatient treatment program.
B) Once I make it through detoxification, I will be free of my addiction.
C) I am not eligible for an outpatient program until I have completed an inpatient program first.
D) )I can expect to get help with other aspects of my life while in treatment.

D

A nurse on the scene following a mass casualty explosion is triaging a client who has a large, open occipital wound and the following findings: respiratory rate 6/min, agonal pattern; capillary refill time 4.5 seconds; nonresponsive to painful stimuli. Which of the following actions should the nurse take?

A) Turn the client to left semi-Fowler’s position and begin assessing the next client.
B) Place a firm pressure dressing to the occiput and open the airway.
C) Apply a cervical spine collar and perform a focused neurological exam.
D) Request that the client be assessed immediately by the next available provider.